Cytomegalovirus (CMV)

October 2007     View PDF     En español

How can I tell if I have CMV disease?

CMV disease most often affects people with HIV when their CD4+ cell counts are below 50. You may also be at risk if you have a slightly higher count (50–100) and have had at least one other opportunistic infection, such as PCP, candidiasis or tuberculosis (TB). A test can measure the level of CMV in the blood. However, high levels of CMV do not always mean there’s active disease somewhere in the body.

CMV can infect almost any part of the body, sometimes in more than one place at a time. In people with HIV, CMV seems prone to infect the eye. If you think you have symptoms that are detailed below, talk to your doctor as soon as possible.

Disease of the eye:
The most common CMV disease in people with HIV is CMV retinitis, or damage to the back of the eye (retina). About 1 out of 4 people living with HIV will develop CMV retinitis, and it remains the leading cause of blindness among them. People with this retinitis sense blurred vision, blind spots or floating spots in the affected eye. Even if treatment is successful, damage to the eye can be permanent. Left untreated, CMV retinitis will lead to blindness.

Disease of the colon:
CMV colitis is the second most common CMV disease in people with HIV. Symptoms include diarrhea, weight loss, loss of appetite, pain in the stomach or chest, blood in the stool, diarrhea and fever. These symptoms are common for many different conditions in HIV disease, which makes it difficult to tell whether they are due to CMV disease or from other diseases of the intestinal tract. It may take several weeks to show that CMV is the cause and not other infections such as fungi, bacteria, parasites or other viruses. CMV can also affect the upper gut including the stomach and small intestine, called CMV gastritis.

Disease of the brain and nerves:
CMV can infect the brain in the form of CMV encephalitis. Symptoms include dizziness, headaches, seizures, personality changes and nervous system problems. Death can occur within weeks or months. When CMV infects the nervous system, it is called polyradiculopathy.

Symptoms include numbness, pain and tingling in the legs, feet, arms and hands, and the loss of muscle, urinary and bowel control. All of these symptoms look like those of other opportunistic infections, so CMV disease may be overlooked as the cause.

Disease of the throat:
CMV esophagitis affects the throat. It can lead to difficult and painful swallowing, chest pain, fever, mouth sores and hiccups.

Disease in newborns:
Congenital CMV is the most common infection in newborns. About 1 in 10 babies born with congenital CMV have symptoms such as a rash, low birth weight, small head, jaundice, and large spleen and liver. Newborns at risk for congenital CMV should be tested for it within the first 3 weeks of birth. See the section “Concerns for children” for more information.